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County BHS is finally acting on the CPP… with highly limited BHAB participation… diametrically opposed to the intent of the MHSA

Last updated on May 15, 2023

A letter to the current Behavioral Health Advisory Board (BHAB):

In today’s BHAB Director’s Report you will hear about a new $2.3m contract (County Contract #566007 signed in May 2022) about UCSD’s role leading our BHS community engagement efforts. You’ll also hear one element being the development of a Council of Community Partners (CCP), a new group the UCSD team will create to collaborate with the UCSD/CHIP/ARC and COR to “make data-informed decisions regarding outreach and engagement efforts, as needed.”(page 36/200 or 11/189)”

I encourage you to read the SOW, because you will find for yourselves just how little you are involved in this process.

The reason for this Advisory Board was to create an equitable panel of people appointed by Supervisors, ideally ones that are politically diverse, and as such you also represent various demographic segments of the behavioral health community. I implore you to examine just how the actions of this BHS is counter-intuitive and counter-productive to authentic, meaningful, informed community engagement throughout the year. (see 9/10/2022 post)

As many know, I filed a complaint with the state, after over six months of no response to queries I made of the BHS Director, Board of Supervisors, and other county leadership, to get answers why we were not following the law and conducting an authentic CPP review process. I was removed from the BHAB the next day.

Since that time several other BHAB members who dared ask tough questions about this BHAB’s work, and the BHS’s reticence to address those questions, have all been removed as well.

I have strong concerns that the San Diego County Behavioral Health Services (BHS) has no interest in the work this Behavioral Health Advisory Board (BHAB) would provide if it had the opportunity. To that end I have to ask, just what is their motive for seeking the BHAB’s typical bobbing-head approval for nearly any vote or recommendation they seek from you? Are they doing that to fulfill their obligations under the law? Why would they then ignore other provisions around the Community Program Planning (CPP) processes so blatantly?

I would also challenge the presumption that, by redirecting the pipeline of feedback into one that is funneled through a pipeline made by a county contractor and senior management oversight , that using science alone to find answers is a method that will only naturally find answers to questions that one asks.

  1. For instance, how hard do you think the BHS will dig to find an acute lack of mental health assessment and care in our jails?

    The State of California Auditor’s February 2022 report, titled San Diego County Sheriff ’s Department |”It Has Failed to Adequately Prevent and Respond to the Deaths of Individuals in Its Custody”

    “We found multiple instances of individuals who requested or required medical and mental health care and did not receive it at all or in a timely manner.”

    So far this year 15 people have died in our jail’s care. The state’s audit was completed this spring because of the alarming number of deaths of people in our direct care. The report listed glaring deficiencies in our jails abilities and practices to manage a population with acute mental health needs.

    How many times did the phrase ‘mental health’ get mentioned in the audit? One-hundred fifty-eight (158).

    How many times did the word jail get mentioned in the Contract? Once (1), and not referenced within the contract’s Statement of Work.
  2. How hard will the BHS dig for answers about our homeless crisis?
  3. How hard will the BHS dig when considering the number of opioid overdoses and the overdose death rate countywide?

The point is, an isolated echo-chamber feedback loop, with intentional dismissal of the state-mandated oversight board’s (BHAB) intimate involvement, is one that is doomed to sustain the status quo.

Another concern is, I was under the impression that typically, county contracts are overseen by a Contracting Officer’s Representative within the contracting department to ensure the provider and county agencies doing the work stay on track, a kind of check and balance. In this contract’s case the COR is a senior member of the BHS staff, and IMO making it highly unlikely there will be much critical feedback if things were to get off-track.

What is BHAB Going to Do?

Well, it’s time this BHAB stopped pussyfooting around the issue. Yes, it’s tough. Yes, it’s work. But, if you received the same training I did (multiple times) provided by the CalBHBC – whose board our BHAB Chair sits on today, you would know that nothing I have questioned or inquired about was out of line and outside of our responsibility.

So, at least know where you stand. The fact leadership chose to create a RFP in the spring to hire a vendor to run our community engagement program, with terms and conditions you did not have an opportunity to contribute one idea or one word to describe, then sign the contract, begin secretively deploying it’s work, and only now months later updating you about it’s existence, and seeing you are nearly literally kept outside of the conversation much less direction, and ultimately a practice that will force you to continue your spectator-role, should alarm you.

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